丙泊酚复合雷米芬太尼靶控输注对老年腹腔镜胆囊切除术麻醉效果观察  

Clinical effect observation of propofol combined with remifentanil by target-controlled infusion for laparoscopic cholecystectomy in elderly group

作　　者：刘德君[1] 

机构地区：[1]郑州大学第二附属医院麻醉科,450014

出　　处：《中国实用医刊》2015年第8期44-45,共2页Chinese Journal of Practical Medicine

摘　　要：目的探讨普外科老年腹腔镜胆囊切除术患者采用雷米芬太尼药物与丙泊酚药物复合靶控输注实施麻醉的临床效果。方法本研究抽取2013年4月至2014年4月收治的老年腹腔镜胆囊切除术患者80例，随机分为对照组和观察组，就静脉复合吸入麻醉（对照组，n=40）与雷米酚太尼复合丙泊酚靶控输注麻醉（观察组，n=40）效果进行对比。结果观察组选取病例术后管道拔除时间、术后苏醒时间均较对照组早，且意识状态较对照组理想，组间各项指标差异均有统计学意义（P〈0．05）。建立CO2气腹后，对照组患者心率、SBP、DBP相对观察组均居较高水平，差异有统计学差异（P〈0．05）。且观察组有较为平稳的血流动力学变化，临床数据在建立CO2气腹5min后变化较小。结论老年腹腔镜胆囊切除术采用丙泊酚复合雷米芬太尼靶控输注，不良反应少，易维持循环稳定，可更好抑制应激反应，术后恢复快，为理想麻醉方法。Objective To investigate the effect of propofol combined with remifentanil by target- controlled infusion for laparoscopic cholecystectomy in elderly group in department of general surgery. Methods Eighty elderly patient who had conducted laparoscopic cholecystectomy from April 2013 to Apill 2014 were selected and randomly divided into control group and observation group（40 cases in each group）. The control group was given intravenous-inhalation combined with anesthesia and the observation group was given propofol combined with remifentanil by target-controlled infusion over the surgerys. Restilts The time of disconnecting pipes and postoperative recovery in observation group was earlier than that of control group, and the mind state was also better. The differences were all statistically significant （ P 〈 0.05 ）. The heart rate, SBP, DBP levels were all higher in control group after establishing CO2 in- sufflation （ P 〈 0.05 ）. What was more, observation group had a more stable hemodynamics, the clinical data changed less obvious after the of CO2 insufflation was established for 5 minutes. Conclusions Propofol combined with remifentanil by target-controlled infusion for laparoscopic cholecysteetomy in elderly group has less adverse reactions; it can maintain loop stability and inhibit the stress response, and the postoperative recovery is faster. Therefore it is a better and effective method of anesthesia.

关 键 词：丙泊酚 雷米芬太尼 靶控输注 老年腹腔镜胆囊切除术 麻醉 

分 类 号：R657.4[医药卫生—外科学]